Repair of Incisional Hernias and Defects in the Anterior Abdominal Wall Using Dermal Grafts

Hagström, Per; Nylén, B

doi:10.3109/02844317609105204

Cited by 18 publications

(6 citation statements)

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“…Histological studies have shown that subcutaneous implantation of FTSG does not give rise to cyst formation or malignant change, and recent animal studies have shown excellent graft survival in the abdominal wall [ 16 , 17 ]. However, interest in this technique faded with the introduction of synthetic materials such as polypropylene and polyester, since when FTSG has only been used sporadically in selected cases [ 18 , 19 ]. Because of the increasing awareness of the problems related to the use of current synthetic materials, it is time to reassess alternative methods such as FTSG [ 5 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial

Holmdahl

Stark

Clay

et al. 2019

Hernia

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Purpose Repair of giant incisional hernia often requires complex surgery and the results of conventional methods using synthetic mesh as reinforcement are unsatisfactory, with high recurrence and complication rates. Our hypothesis was that full-thickness skin graft (FTSG) provides an alternative reinforcement material for giant incisional hernia repair and that outcome is improved. The aim of this study was to compare FTSG with conventional materials currently used as reinforcement in the repair of giant incisional hernia. Methods A prospective randomised controlled trial was conducted, comparing FTSG with synthetic mesh as reinforcement in the repair of giant (> 10 cm minimum width) incisional hernia. One-year follow-up included a blinded clinical examination by a surgeon and objective measurements of abdominal muscle strength using the Biodex-4 system. Results 52 patients were enrolled in the study: 24 received FTSG and 28 synthetic mesh. Four recurrences (7.7%) were found at 1-year follow-up, two in each group. There were no significant differences regarding pain, patient satisfaction or aesthetic outcome between the groups. Strength in the abdominal wall was not generally improved in the study population and there was no significant difference between the groups. Conclusion The outcome of repair of giant incisional hernia using FTSG as reinforcement is comparable with repair using synthetic mesh. This suggests that FTSG may have a future place in giant incisional hernia repair.

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Section: Introductionmentioning

confidence: 99%

One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial

Holmdahl

Stark

Clay

et al. 2019

Hernia

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“…The use of autologous skin as reinforcement in hernia repairs is an alternative method that may lead to lower recurrence and complication rates by avoiding the use of foreign material. Autologous skin graft has been used in hernia repair before, but to our knowledge only in the onlay position (11)(12)(13)(14). Before executing clinical trials on parastomal hernia repair with autologous skin in an intraperitoneal position, experiments on both tissue biology as well as mechanical studies must therefore be performed.…”

Section: Introductionmentioning

confidence: 99%

The Tensile Strength of Full-Thickness Skin: A Laboratory Study Prior to Its Use as Reinforcement in Parastomal Hernia Repair

et al. 2019

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Purpose: Parastomal hernia is a common complication of an enterostoma. Current methods of repair have high recurrence rates and are associated with severe complications. Autologous full-thickness skin as reinforcement may reduce the recurrence and complication rates. This study aims to investigates the tensile strength of full-thickness skin; information that is essential if we are to proceed with clinical trials on humans.Methods: Full-thickness skin samples from 12 donors were tested for tensile strength, as well as the load tolerated by a suture through the skin. Strips of skin were cut out and stretched until breaking point. Sutures were made through skin samples and traction applied until either the tissue or the suture gave way. All done while recording the forces applied using a dynamometer. Identical tests were carried out on commercially available synthetic and biologic graft material for comparison. Results:The full-thickness skin strips had a median tensile strength of 604 N/cm. This tensile strength was significantly higher than that of the compared materials evaluated in this study. In full-thickness skin, the suture, or tissue endured a median force of 67 N before giving way, which was as high as, or higher than similar sutures through the compared materials. Conclusions:The tensile strength of full-thickness skin vastly exceeds the physiological forces affecting the abdominal wall, and sutures through skin endure high loads before giving way. The tensile strength of a full-thickness skin graft and the strength of sutures through this material will not limit its use for reinforcement in parastomal hernia repair.

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“…The use of autologous deepithelialized and nondeepithelialized skin for inguinal and ventral hernia repair has been described in the literature as an "auto-dermoplasty" for abdominal wall reconstruction. 31 Therefore, the concept of using biologic tissue for structural repair of abdominal wall defects is not necessarily a new concept. 32 Bioprosthetic mesh materials are defined as biologic tissue derived from a mammalian source, either allograft or xenograft.…”

Section: Evolution Of the Use Of Bioprosthetic Meshmentioning

confidence: 99%

Bioprosthetic Mesh in Abdominal Wall Reconstruction

Baumann

Butler

2012

Seminars in Plastic Surgery

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Mesh materials have undergone a considerable evolution over the last several decades. There has been enhancement of biomechanical properties, improvement in manufacturing processes, and development of antiadhesive laminate synthetic meshes. The evolution of bioprosthetic mesh materials has markedly changed our indications and methods for complex abdominal wall reconstruction. The authors review the optimal properties of bioprosthetic mesh materials, their evolution over time, and their indications for use. The techniques to optimize outcomes are described using bioprosthetic mesh for complex abdominal wall reconstruction. Bioprosthetic mesh materials clearly have certain advantages over other implantable mesh materials in select indications. Appropriate patient selection and surgical technique are critical to the successful use of bioprosthetic materials for abdominal wall repair.

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Repair of Incisional Hernias and Defects in the Anterior Abdominal Wall Using Dermal Grafts

Cited by 18 publications

References 1 publication

One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial

One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial

The Tensile Strength of Full-Thickness Skin: A Laboratory Study Prior to Its Use as Reinforcement in Parastomal Hernia Repair

Bioprosthetic Mesh in Abdominal Wall Reconstruction

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